[Federal Register Volume 89, Number 122 (Tuesday, June 25, 2024)]
[Notices]
[Pages 53110-53112]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-13857]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Submission to OMB for 
Review and Approval; Public Comment Request; Ryan White HIV/AIDS 
Program Core Medical Services Waiver Form

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, HRSA 
submitted an Information Collection Request (ICR) to the Office of 
Management and Budget (OMB) for review and approval. Comments submitted 
during the first public review of this ICR will be provided to OMB. OMB 
will accept further comments from the public during the review and 
approval period. OMB may act on HRSA's ICR only after the 30-day 
comment period for this notice has closed.

DATES: Comments on this ICR should be received no later than July 25, 
2024. The form will become effective on October 1, 2024.

ADDRESSES: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under Review--Open for 
Public Comments'' or by using the search function.

FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance 
requests submitted to OMB for review, email Joella Roland, the HRSA 
Information Collection Clearance Officer, at [email protected] or call 
(301) 443-3983.

SUPPLEMENTARY INFORMATION: 
    Information Collection Request Title: Ryan White HIV/AIDS Program 
Core Medical Services Waiver Form, OMB No. 0906-0065--Revision
    Abstract: In accordance with sections 2604(c), 2612(b), and 2651(c) 
of the Public Health Service Act, recipients are required to spend not 
less than 75 percent of funds on core medical services for individuals 
identified with HIV and who are eligible under the statute, after 
reserving permissible amounts for administrative and clinical quality 
management (CQM) costs. The statute also grants the Secretary authority 
to waive this requirement for a Ryan White HIV/AIDS Program (RWHAP) 
Part A, B, or C recipient if certain requirements are met, and a waiver 
request is submitted to HRSA for approval.
    As currently implemented by HRSA, in order to be approved, (1) core 
medical services must be available and accessible to all individuals 
identified and eligible for the RWHAP in the recipient's service area 
within 30 days. This access must be without regard to payer source, and 
without the need to spend at least 75 percent of funds

[[Page 53111]]

remaining from the recipient's RWHAP award after statutorily 
permissible amounts for administrative and CQM costs are reserved; (2) 
the recipient must ensure there are no AIDS Drug Assistance Program 
(ADAP) waiting lists in its service area; and (3) a public process to 
obtain input on the waiver request must have occurred. This process 
must seek input from impacted communities, including clients and RWHAP-
funded core medical services providers, on the availability of core 
medical services, and the decision to request the waiver. The public 
process may be a part of the same one used by recipients to seek input 
on community needs as part of the annual priority setting and resource 
allocation, comprehensive planning, statewide coordinated statement of 
need, public planning, and/or needs assessment processes. RWHAP Parts 
A, B, and C core medical services waiver requests must include funds 
awarded under the Minority AIDS Initiative. Core medical services 
waivers are effective for a 1-year period.
    The process for RWHAP Parts A, B, and C grant recipients to request 
a waiver of the minimum expenditure amount requirements for core 
medical services is outlined in Policy Notice 21-01, Waiver of the Ryan 
White HIV/AIDS Program Core Medical Services Expenditure Requirement. 
Policy Notice 21-01 is currently being revised and will be effective 
October 1, 2024.
    HRSA proposes to modify the one-page form to include the proposed 
percentages of HIV service dollars allocated to core medical and 
support services. Under the proposed changes, a field will be added to 
the form to capture the proposed percentages. This information will 
inform HRSA whether recipients are able to meet the statutory 
requirements in sections 2604(c), 2612(b), and 2651(c) of the Public 
Health Service Act and will clarify what proposed portion of funds will 
be allocated to core medical and support services. Minor changes will 
also be made to the form to increase readability.
    Summary of Proposed Changes: Sections 2604(c), 2612(b), and 2651(c) 
of the Public Health Service Act require recipients to spend not less 
than 75 percent of funds on core medical services after reserving 
statutorily permissible amounts for administrative and CQM costs. 
However, on the current version of the form, the portion of HIV service 
dollars to be allocated to core medical and support services was 
sometimes unclear. The suggested change to the form adds a requirement 
to include the proposed percentages of HIV service dollars allocated to 
core medical and support services. The table on the current form is 
expanded to allow for the insertion of the proposed percentages for 
core medical and support services. Instructions at the top of the new 
form are updated to indicate where to insert the proposed percentages. 
Language within the table is also updated to increase readability.
    The proposed changes do not modify the underlying requirements 
necessary to obtain a waiver: all core medical services are available 
and accessible within 30 days in the jurisdiction or service area; 
ensuring that the state ADAP has no waiting lists; and that the 
recipient has used a public process to determine the need for a waiver. 
Recipients may still need to provide supportive evidence to HRSA upon 
request.
    A 60-day notice published in the Federal Register on February 27, 
2024, vol. 89, No. 39; pp. 14507-14508. There were no public comments.
    Need and Proposed Use of the Information: HRSA uses the 
documentation submitted in core medical services waiver requests to 
determine if the RWHAP Parts A, B, and C grant applicant or recipient 
meets the statutory requirements for waiver eligibility including: (1) 
no waiting lists for ADAP services; and (2) evidence of core medical 
services availability within the grant recipient's jurisdiction, state, 
or service area to all persons identified with HIV and eligible under 
Title XXVI of the Public Health Service Act.
    Likely Respondents: HRSA expects responses from RWHAP Parts A, B, 
and C grant applicants and recipients. The number of grant recipients 
requesting waivers fluctuates annually and has ranged up to 23 per year 
since its implementation in fiscal year 2007. In light of recent 
trends, HRSA anticipates receiving possibly up to 23 applications in a 
given year.
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain, disclose, or provide the 
information requested. This includes the time needed to review 
instructions; to develop, acquire, install, and utilize technology and 
systems for the purpose of collecting, validating, and verifying 
information, processing and maintaining information, and disclosing and 
providing information; to train personnel and to be able to respond to 
a collection of information; to search data sources; to complete and 
review the collection of information; and to transmit or otherwise 
disclose the information. The total annual burden hours estimated for 
this ICR are summarized in the table below.

                                     Total Estimated Annualized Burden Hours
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                                                     Number of                    Average burden
            Form name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         hours
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RWHAP Core medical Services                   23               1              23            0.49           11.27
 Waiver request Attestation Form
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    Total.......................              23  ..............              23  ..............           11.27
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[[Page 53112]]

    HRSA specifically requests comments on (1) the necessity and 
utility of the proposed information collection for the proper 
performance of the agency's functions, (2) the accuracy of the 
estimated burden, (3) ways to enhance the quality, utility, and clarity 
of the information to be collected, and (4) the use of automated 
collection techniques or other forms of information technology to 
minimize the information collection burden.

Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2024-13857 Filed 6-24-24; 8:45 am]
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